Postural Balance in the Elderly with Mild Cognitive Impairment: Relationship to Accidental Falls

This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64 and 88 years old, mostly females. Data collection was performed in two Basic Health Units in the city of Rio de Janeiro in 2014. The instruments used were the Mini-Mental State Examination (MMSE), Tinetti scale, Motor Scale for the Elderly (EMTI) scale, and Elderly Falls Diary. The data were analyzed with the SAS statistical software version 9.3.1. The scales were applied before and after the psychomotor interventions. A significant difference was observed between the evaluating moments. Balance improvements were observed in all age groups, suggesting that all elderlies, regardless of age, showed satisfactory responses to the implemented psychomotor activities. The elderlies who fell more frequently were those between 60 and 69 years old. It is noteworthy that the age group with the lowest incidence of falls was that of elderlies between 70 and 79 years old. It was concluded that psychomotor activities are beneficial, regardless of age, proving their effectiveness when continued stimuli with cognitive and psychomotor activities are carried out.

Application of a hospital–community–family trinity rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction

BACKGROUND Rehabilitation nursing is considered an indispensable part of the cerebral infarction treatment system.The hospital–community–family trinity rehabilitation nursing model can provide continuous nursing services across hospitals,communities,and families for patients.AIM To explore the application of a hospital–community–family rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction.METHODS From January 2021 to December 2021,88 patients with cerebral infarction were divided into a study(n=44)and a control(n=44)group using a simple random number table.The control group received routine nursing and motor imagery therapy.The study group was given hospital–community–family trinity rehabilitation nursing based on the control group.Motor function(FMA),balance ability(BBS),activities of daily living(BI),quality of life(SS-QOL),activation status of the contralateral primary sensorimotor cortical area to the affected side,and nursing satisfaction were evaluated before and after intervention in both groups.RESULTS Before intervention,FMA and BBS were similar(P>0.05).After 6 months’intervention,FMA and BBS were significantly higher in the study than in the control group(both P<0.05).Before intervention,BI and SS-QOL scores were not different between the study and control group(P>0.05).However,after 6months’intervention,BI and SS-QOL were higher in the study than in the control group(P<0.05).Before intervention,activation frequency and volume were similar between the study and the control group(P>0.05).After 6 months’intervention,the activation frequency and volume were higher in the study than in the control group(P<0.05).The reliability,empathy,reactivity,assurance,and tangibles scores for quality of nursing service were higher in the study than in the control group(P<0.05).CONCLUSION Combining a hospital–community–family trinity rehabilitation nursing model and motor imagery therapy enhances the motor function and balance ability of patients with cerebral infarction,improving their quality of life.

Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study

Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.

The Application of Scales in the Diagnosis of Perceived Needs in the Elderly with Mild Cognitive Impairment

The study evaluated the use of the Mini-Mental State Examination scale (MMSE), Tinettiscale, and Motor Scale for the Elderly (EMTI) toassist in the diagnosis of potential needs observed in elderlies with Mild Cognitive Impairment. This was aquasi-experimental research, conducted in a Basic Health Unit in thecityof Rio de Janeiro in 2014. The sample population consisted of 22 elderlies aged 64 to 88 years and 86.36% females. The SAS statistical software (version 9.3.1) and Kruskal-Wallis test were used at a 95% confidence interval and a significance level of 0.05 and demonstrated significant differences in the evaluations performed before and after the intervention. The detected diagnoses were: impaired memory, the risk of falls, and willingness to improved relationships, among others. The evaluations showed MMSE results that were suggestive of cognitive impairment in 22.73% of the elderlies;the Tinetti scale showed a high risk of falls in 31.82% of theelderlies;and EMTI with 88.36 points, which was equivalent to the normal low classification. The intervention took place through ten weekly activity sessions after the initial evaluations. In the second evaluation, the Tinetti showed 59.09% of the elderlies with a moderate risk of falls and the EMTI as the normal average classification with 90.32 points. It was concluded that the scales offered diagnostic possibilities, which allowed for the implementation of necessary interventions according to the detected problems.